Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis.
[BACKGROUND] In patients with newly diagnosed metastatic prostate cancer (mPCa), the appropriate population for radical prostatectomy (RP) remains unclear.
- 95% CI 0.27-0.54
- HR 0.38
APA
Zhang X, Pan S, et al. (2025). Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis.. Journal of investigative surgery : the official journal of the Academy of Surgical Research, 38(1), 2534579. https://doi.org/10.1080/08941939.2025.2534579
MLA
Zhang X, et al.. "Survival Benefit of Radical Prostatectomy in Newly Diagnosed Metastatic Prostate Cancer Varies by PSA Level and Site of Metastasis.." Journal of investigative surgery : the official journal of the Academy of Surgical Research, vol. 38, no. 1, 2025, pp. 2534579.
PMID
40692172
Abstract
[BACKGROUND] In patients with newly diagnosed metastatic prostate cancer (mPCa), the appropriate population for radical prostatectomy (RP) remains unclear.
[PATIENTS AND METHODS] Newly diagnosed mPCa patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into no local therapy (NLT) and RP groups. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier curves were used to estimate cancer-specific survival (CSS).
[RESULTS] A total of 9,215 patients were included, with 8,844 receiving NLT and 371 undergoing RP. After PSM, 321 patients in each group were included. RP was associated with significantly better CSS (HR = 0.38, 95% CI, 0.27-0.54, < 0.001). Subgroup analyses showed consistent survival benefit of RP except in patients with M1c disease (HR = 0.55, 95% CI, 0.21-1.46, = 0.229) or PSA ≥60 ng/ml (HR = 1.19, 95% CI, 0.53-2.86, = 0.673). An exploratory classification defined low tumor burden as PSA <60 ng/ml and M1a/M1b disease, and high tumor burden as PSA ≥60 ng/ml or M1c. RP significantly improved CSS in the low tumor burden group (HR = 0.30, 95% CI, 0.20-0.46, < 0.001), but not in the high tumor burden group (HR = 0.98, 95% CI, 0.53-1.84, = 0.961).
[CONCLUSION] In patients with newly diagnosed mPCa, the survival benefit of RP varies with tumor burden.
[PATIENTS AND METHODS] Newly diagnosed mPCa patients were identified from the Surveillance, Epidemiology, and End Results (SEER) database and divided into no local therapy (NLT) and RP groups. Propensity score matching (PSM) was used to balance baseline characteristics. Kaplan-Meier curves were used to estimate cancer-specific survival (CSS).
[RESULTS] A total of 9,215 patients were included, with 8,844 receiving NLT and 371 undergoing RP. After PSM, 321 patients in each group were included. RP was associated with significantly better CSS (HR = 0.38, 95% CI, 0.27-0.54, < 0.001). Subgroup analyses showed consistent survival benefit of RP except in patients with M1c disease (HR = 0.55, 95% CI, 0.21-1.46, = 0.229) or PSA ≥60 ng/ml (HR = 1.19, 95% CI, 0.53-2.86, = 0.673). An exploratory classification defined low tumor burden as PSA <60 ng/ml and M1a/M1b disease, and high tumor burden as PSA ≥60 ng/ml or M1c. RP significantly improved CSS in the low tumor burden group (HR = 0.30, 95% CI, 0.20-0.46, < 0.001), but not in the high tumor burden group (HR = 0.98, 95% CI, 0.53-1.84, = 0.961).
[CONCLUSION] In patients with newly diagnosed mPCa, the survival benefit of RP varies with tumor burden.
MeSH Terms
Humans; Male; Prostatectomy; Prostatic Neoplasms; Prostate-Specific Antigen; Middle Aged; Aged; SEER Program; Kaplan-Meier Estimate; Propensity Score; Retrospective Studies; Tumor Burden; Treatment Outcome; Neoplasm Metastasis; Prostate
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